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Emergency Medical Associates (EMA), a consortium of doctors that contract to staff and run 21 New York and New Jersey hospital emergency departments, is tapping BI software from SAP Business Objects to monitor patient data to detect upticks in symptoms like cough and fever that could portend an onslaught of swine flu cases.

Even an increase of just 1% in flu-like symptoms could signify a coming influx of swine flu patients, according to Jonathan Rothman, head of EMA's data management operations. Such a slight increase would be nearly imperceptible to emergency room doctors and nurses, he said, if not for BI software.

If and when a potential increase in patients is detected via Business Objects XI-based reports and dashboards, which tap data from EMA's underlying, homegrown electronic medical records (EMR) system and an Oracle 10g database, administrators can take appropriate action, like increasing staff and supplies, Rothman said.

"We don't have the choice, as an emergency department, to treat some patients and not others," Rothman said. He noted that media attention increases the likelihood of people who suspect they have swine flu, but don't, inundating emergency rooms. "We treat everyone," he said.

But, not all emergency departments may be able to take advantage of BI technology like EMA-run emergency rooms do. Most hospitals – more than 90% by some estimates -- lack electronic medical records that feed patient data to BI and analytic software. More hospitals are likely to invest in the technology, thanks to President Obama's push to digitize all medical records, but it will still be years before adoption picks up on a large scale.

In addition, hospital budgets are tight because of the current recession, putting expensive BI technology like that from SAP and others, which can run into the hundreds of thousands and even millions of dollars, largely out of reach for the moment.

EMA developed its EMR system more than 10 years ago, Rothman said, but data was only integrated and reported on a monthly basis. Following the 9/11 attacks and subsequent Anthrax scare, EMA decided it needed to integrate data in as near to real-time as possible to track potential biological or chemical warfare attacks.

"With 9/11, the need to integrate data in as close to real time as possible was our biggest challenge," Rothman said. This required building new ETL processes storage schemas inside its data warehouse.

"The time and effort [needed] to build this required tremendous learning," Rothman said. Patient data is now integrated in near real-time for daily and even hourly monitoring.

While the cause of swine flu is naturally occurring, rather than a biological attack, EMA's investment in BI and data integration technology is helping hospitals, including Clara Maass Medical Center in Belleville, N.J., and Meadowlands Hospital in Secaucus, N.J., stay ahead of the virus.

One day last spring, as swine flu began to make its way throughout Mexico and into the United States, one EMA-run emergency room saw a nearly 50% increase in patients, from an average of 220 per day to 320. With the help of BI software, the hospital was able to predict a steady increase of patients going forward, giving them time to staff up and create mechanisms for quarantining potential swine flu patients as they arrived at the emergency room, Rothman said.

"If tomorrow I run this report and all of sudden we start seeing total visits that shoot above average, I'm going to start looking into whether this is a one-day thing, what's causing it, where is this happening," Rothman said. "If you're not staffed appropriately, you have mayhem."

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